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Published on Dec 7, 2009
As the healthcare debate rages in the US, the fate of the hundreds of thousands of mentally ill people in jails and prisons in the US has been absent from the agenda.
Homelessness has become a part of the landscape of every major city and town in the US, but it is often more than poverty that is to blame for the plight of the homeless.
While there are no exact figures, advocacy groups estimate that as many as 80 per cent of homeless people suffer from mental illness.
For many, this sad reality eventually leads to confrontations with the law, which explains how the mentally ill have come to make up more than half of the US prison population.
Houston in Texas has one of the nation's largest homeless populations. Incidents across the country in which police officers have shot and killed mentally ill individuals have forced law enforcement officials here to re-think their approach.
"As the years passed, we decided to take advantage of the resources of the mental health community," Chief Harold Hurrt of the Houston police says.
"And now, we are much more professional in our response in that we realise that jail is not the answer."
Houston is home to the nation's largest Crisis Intervention Team (CIT) unit. The programme partners police officers with mental health clinicians who attempt to allow distressed mentally ill individuals to recover in hospitals rather than detention facilities.
However, public hospitals are under-funded and over-crowded, meaning that if they offer any psychiatric services at all, it is only for the short term.
Psychiatrists say jail is not an ideal environment to treat inmates. Meanwhile, long-term stay facilities have all but disappeared throughout the US.
Fewer than 40,000 Americans currently reside in psychiatric hospitals, while according to the Department of Justice, 30 times that number - 1.25 million mentally ill people - are serving time in US prisons.
In a special report, Fault Lines' Josh Rushing visited detention facilities in Texas to discover how inmates with mental illness are treated.